In the United States, approximately 16 million people (6 percent of the population) suffer from diabetes mellitus. Every year, about 800,000 new cases are diagnosed and another 6 million people remain unaware that they have the disease. Diabetes mellitus kills about 193,000 U.S. residents each year, and it is the seventh leading cause of all deaths and the sixth leading cause of all deaths caused by disease. There is a steady rise in children developing type 2 diabetes. In Canada, more than 2.2 million residents (7 percent of the population) have diabetes mellitus, and the disease contributes to more than 25,000 deaths a year.
Adenocarcinoma of the pancreas is the fifth most common cause of cancer death in the United States. In the U.S., almost 45,000 people become affected with pancreatic cancer every year. Cancer most often occurs in the pancreatic head and often leads to biliary obstruction with a clinical presentation of painless jaundice. The 5 year survival rate for resectable patients is about 10% with a median survival of 12 to 18 months. Unresectable patients live about 6 months. Both diseases are associated with pancreatic function. Also, risk for pancreatic cancer is increased in adult-onset diabetics.
In the pancreas, the Islets of Langerhans are composed of four cell types, each of which synthesizes and secrets a distinct polypeptide hormone: insulin in the beta cell (60%), glucagon in the alpha cell (25%), somatostatin in the D cell (10%), and pancreatic polypeptide in the F cell (5%). Beta cells are the major type of cells in the pancreas. Certain nutrients and growth factors can stimulate pancreatic beta-cell growth. However, the appropriate mitogenic signaling pathways in beta-cells have been relatively undefined. This failure to define these important signaling pathways is due at least in part to a lack of effective imaging technologies.
The current status of imaging in pancreatic diseases has been recently reviewed by Kalra et al. Journal of Computer Assisted Tomography 26:661-675. The reviewed technologies include CT, MRI, EUS and PET scans.